Laparoscopy is a surgical procedure performed through small incisions in the abdomen whereby a trocar device is inserted to provide a means for passage of medical instruments. A thin cylindrical instrument called a laparoscope, connected to a camera, is then used to provide a clear picture of the abdominal cavity to the surgeon.
In particular, prior to starting a surgical procedure a small incision is made in the abdominal wall of the patient whereby a trocar/cannula device is inserted. Trocar device diameters range in size from 5 to 12 mm and provide a clear passage for the introduction of medical devices into the abdomen. Once the abdominal opening is secured, a laparoscope is inserted thru the trocar opening permitting the surgeon to view the abdominal cavity space. Typically, several additional incisions are made ranging in size from 5-12 mm for the introduction of other medical devices. A device called an insufflator is also used; its purpose is to inflate the abdominal cavity area with carbon dioxide and create space. The space created provides a greater working and viewing area for the surgeon.
Minimally invasive surgeries such as laparoscopies may provide a host of benefits as compared to traditional surgeries using large incisions, including lower operating cost, less patient trauma, less scarring, less pain, lower surgical complications, quicker recovery times, shortened hospital stays, and less chance of infection.
As the field of minimally invasive surgery continues evolving, less invasive techniques are desired. The need for smaller laparoscopic tools has also arisen. In recent years, a newer version of laparoscopy has evolved called needlescopic surgery. Needlescopic surgery is a progression of laparoscopic surgery whereby incisions smaller than 3 millimeters are made. Virtually no scarring occurs, pain is reduced, and recovery times are faster. However the problem associated with this new type of procedure is the limited functionality of the insertion instrument. As the instruments became thinner, the heads of the instruments became smaller and less effective to manipulate tissues and organs. For this reason among others, needlescopic surgery has not been widely adopted by the surgical community.
Another new type of surgery called Single Incision Laparoscopic Surgery (SILS) has also been tried to reduce the number of incisions related to surgery. The concept is that a single incision is made at the umbilicus allowing a specialized tool to be placed at the opening. The opening allows the insertion of several very small instrument tools into the abdomen. The problems associated with this procedure are first in the level of complexity for each procedure versus the traditional laparoscopic procedure, the lack of functionality of the smaller tools, and the very tight working area. It is usually limited to only 3 very small instrument devices which often lack the full functionality required by traditional surgeons.
Another new type of surgery used today is called Natural Orifice Translumenal Endoscopic Surgery (NOTES). It basically involves placing a flexible endoscope through one of the body's natural orifices, like the mouth, anus, vagina, or urethra. Its purpose is to achieve access to a space near the affected area. Some of the problems associated with this type of surgery are that the number of instrument heads used is usually limited to only one, not all areas of the body are accessible, and since most views are two dimensional there are special orientation problems.
An additional problem associated with both Single Incision Laparoscopic Surgery (SILS) and Natural Orifice Translumenal Endoscopic Surgery (NOTES) is the inability to achieve triangulation. Triangulation in this instance can be defined as the ability to come at a target from different directions or angles. Triangulation provides significant benefits to the surgeon, among them are: effective control of the surgical procedure and the ability to better manipulate internal body parts. When this ability is lost it is difficult to effectively perform these types of surgeries. This is one of the reasons that have prevented SILS and NOTES from being widely adopted.
People have experimented with the concept of attaching larger instrument heads to thin shafts inside the body, but no effective method has been developed or invented to facilitate the insertion and attachment of such instrument heads within the body, especially under direct visualization.
It has been a long term goal of minimally invasive surgeons to perform surgery with the absolute smallest incisions while providing the means of visualization of the intended area. Therefore there is a need in the field for a means of effectively attaching and securing full-sized laparoscopic instrument heads to small diameter instrument shafts within the body while under direct visualization. This need would minimize the number and size of incisions performed for each procedure. The challenge with this approach is that the current methods used require additional trocar/cannula openings.
In laparoscopic surgery, incisions are made ranging from 5-12 mm and usually require up to 4 separate incisions. In the specialized field of needlescopic surgery the instrument heads are often too small and lack functionality. Visualization of the attachment process is also a problem that has limited the internal attachment process to an external one. The challenge has been in finding a means of inserting, removing and remotely attaching a normal sized medical instrument head inside the abdomen of a patient. The benefits are numerous to the patient including; reduced scarring, quicker recovery times, less chance of infections, and lower morbidity risks associated with infections. The advantages to the surgeon are better handling, and better functionality of the instrument heads, often a trade off that is associated with smaller instrument heads.
As newer technologies continue to evolve, there is a need in the field for smaller tools having better rigidity and strength characteristics. In U.S. Provisional Application Ser. No. 62/093,789, filed on Dec. 18, 2014, entitled “Method and Apparatus for Securing Laparoscopic Instrument Heads in the Abdomen Under Direct Visualization”, which is hereby incorporated by reference herein in its entirety, a new technology was disclosed whereby thin shafts having diameters measuring between 1-4 mm are introduced into a patient's body. As elongated instruments continue to reduce in diameter, however, rigidity of such instruments can become problematic. In particular, the further such instruments are extended the weaker they become. Therefore it is the goal of this invention to provide a means of providing rigidity and enhanced strength to elongated medical instruments by the introduction of a strengthening sleeve device.
These and other aspects, features and advantages of the present invention will become more readily apparent from the attached drawings and the detailed description of the preferred embodiments which follow.